Provider Demographics
NPI:1770630618
Name:WYOMING CENTRAL SCHOOL
Entity Type:Organization
Organization Name:WYOMING CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-495-6222
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:NY
Mailing Address - Zip Code:14591-0244
Mailing Address - Country:US
Mailing Address - Phone:585-495-6222
Mailing Address - Fax:585-495-6341
Practice Address - Street 1:1225 STATE RT 19
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:NY
Practice Address - Zip Code:14591-0244
Practice Address - Country:US
Practice Address - Phone:585-495-6222
Practice Address - Fax:585-495-6341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01426659Medicaid